Hey, I'm back to start on one new chapter on Olfaction and Inquiry in all that I have left out before the long side-tract on Bone Proportion Measurement. This is How to use Observation, Olfaction, Inquiry\Auscultation, and Palpation in Paediatrics(part 11).
The Olfaction comprises of 2 applications which are listening and sniffing. Predominantly, the general principles of TCM Fundamentals on:
should be already understood and master when listening to the:
- Tone and Articulation of language
- Crying sound
of the infant stage to the preschooler stage.
Olfaction and Inquiry
I'll be elaborating more on the aforesaid TCM Fundamentals in Olfaction touching on the following:
- Tone and Articulation of Language
- Crying Sound
- Coughing Sound
- Breathing Sound
- Sniffing the bad breath, urine and faeces
Tone and Articulation of Language
Under normal conditions, the tone and articulation of the language are clear and audible.
On the contrary, if the tone and articulation are:
- Soft and weak=Qi deficiency
- Moaning=Uncomfortable
- Inconsistent sharp crying=Pain
- Delirium related articulation=Intensified Heat in the Ying level commonly seen in febrile illness. (Febrile illness is either having a fever of 38°C and higher when presented to the doctor or having a history of persistent fever lasting 2 to 7 days without localising sign{FWLS}. The common cause of fever without localizing sign is a viral infection. The challenge here is the difficulty in distinguishing the serious bacteria illness from a viral illness.)
Crying Sound
Under normal conditions, the crying sound of the baby should be magnificent and long. It is appropriate to check on the feeding schedule and wet diaper when the baby is crying.
- More often than not, the cry for hungry is long and weak. Sometimes, certain babies will make an oral sucking gesture but not all.
- Inconsistent sharp crying=stomachache
- Hoarse or raspy, hard to hear crying coupled with not breathing smoothly=throat oedema
Coughing Sound
There is one prerequisite for the cough to classified as mild: the coughing sound must be smooth and phlegm easily cough out.
The rest is classified as acute and severe in the TCM perspective with the following sound:
- Coughing sound is clear with transparent nasal mucus=exogenous flu caused by the cold wind
- The coughing sound is hoarse with thick yellowish phlegm=exogenous flu caused by hot wind
- Dry cough is noted when there is no phlegm at all=Lung dryness or caused by throat inflammation. (sore)
- Coughing sound similar to a dog's barking=inflammation of the upper respiratory tract or caused by Diphtheria.
Breathing Sound
Breathing Sound in term of pathological analysis are as follow:
- Breathing sounds deep with strength always mistaken as shortness of breath= exogenous flu caused by hot wind
- Notice a little bit of shortness of breath coupled with breathing through the mouth =stuffy nose
- Shortness of breath coupled with a wheezing sound in the upper respiratory tract=asthma caused by phlegm gathers in the lung deeply.
- Shortness of breath coupled with nasal flaring=pneumoniatic cough
- Observe respiratory distress, face turn greenish and with no coughing sound=airway obstruction
- Low breathing with two inhales and then one exhale better known as a double aspiration in the TCM perspective and sounds like crying=critical illness with Lung Qi coming to extinct in the TCM perspective.
Sniffing the bad breath, urine and faeces
In this category, sniffing inspects only these 3 areas to analyse the pathological phenomena:
Bad breath
- Foul or disgusting breath =caused by Heat from the Lung and Stomach steaming the turbid odour to rise and exit through the mouth.
- Stinky breath=Swollen and ulcerated gums bleeding pus
- Sour and smelly breath=indigestion
- Fishy breath=related to haemorrhage commonly found in bleeding gum
Urine
- Quantity less, slightly reddish with stinky smell=wetness and heat concentrated in the abdomen
- Quantity more, not smelly=spleen and kidneys deficiency especially in cold
Faeces
- Foul and smelly=wetness and heat stagnation
- Sour and watery=ingestion
- Food residues or chyme found without any bad smell=spleen and kidneys deficiency in TCM perspective.
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Sian Xiong
***Reference:
( Emperor's Interior Sutra is available on sales better known as the esoteric scripture of the yellow emperor in Amazon, it's just a different way of naming the book cover)
